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Sunday, December 15, 2013

Going Re-Certifiably Crazy!

Well, this past week or so has been a doozy as far as my frustration level goes.

First, there was all the government forms to fill out to "re-certify" Bob for his benefits. We have to do this re-certification every six months for some darn reason and every six months they want not only cumbersome online forms filled out (including listing all household expenses etc.) but also photocopies of his medical expenses sent to them. This time, while filling out the online form, when I was at the very last page, and had spent nearly two hours filling out these darn forms, the system kicked me out and I had to START ALL OVER --- gggggrrrrowl! Then, while photocopying the medical expense receipts/invoices, my @#! printer kept telling me "FATAL PRINTER ERROR!" and shutting down. Double gggrrrowl! But I finally got it all together then had to rush out to the post office, park two blocks away as the parking lot was filled, wait in a long, long line of folks sending off Christmas packages.... ggrrrr....

But that's done.

Add to this, physical therapy is all screwed up.

You'd think, after a doctor orders PT and the insurance approves it, well, we should be all set for the approved 20 sessions before the end of the year.

At least, that's what I thought. Until the PT doesn't call to set up appointments. And I have to call her, and wait for her to call back only to be told that Bob needs a "re-certification" (there's that word again!) from the PT evaluator, so the PT evaluator is supposed to be calling me to set up a time. So, I wait again, no one calls.

So, I call the agency and get some answering machine and leave a message. When I get a return call, finally, I am told THEY DON'T HAVE A SCRIPT for PT. And I'm thinking, how can they NOT have a script when the insurance has already sent ME a letter approving it?? I mean, someone had to send the script to the insurance company and THAT would've been the agency, right?

Good grief.

On top of that, the home health agency decides to send a different nurse here last week because we also need a Home Health Re-Certification, which is different than a PT Re-Certification. I talk to this nurse on the phone and ask him why he's coming. Because it makes no sense to me as we always have the same nurse for re-certifications, the one who comes every eight weeks to replace Bob's feeding tube. But the nurse insists he has to come to do the re-certification and I ask him, since he's coming, would he please check on the PT situation as it seems they've lost the script and he says he will.

So when the nurse comes on Tuesday, he tells me that he checked on the PT order and found the insurance had ONLY APPROVED ONE SESSION FOR NOVEMBER. And I'm like, WHAT???!!!

So, I show him the copy of the letter the insurance company sent to me approving 20 more sessions through the end of the year. And he agrees with me, they must have a script for that, or I wouldn't have gotten the letter. So he takes a copy of the Approval Letter from the insurance company back to the home health agency.

Then on Wednesday, our regular home health nurse calls and says she needs to come over and do a RE-CERTIFICATION. And I'm thinking, You've Got to be Kidding!? And tell her so. She tells me that she was not aware of anyone else coming over to do a re-certification and she'll check into it. I also tell her about the PT problem we are having. And she says she'll look into that, too.

And she calls me back.

And tells me, that the home health agency screwed up and sent the other nurse to do a "weekly evaluation" because someone thought Bob was having "weekly home health care" instead of every eight weeks. Anyway, this nurse still needs to come on Friday to do the actual Re-Certification.

Which she did. And she promises to correct the PT problem, too. She promises someone will call to set up the PT Re-Certification. Let's hope they do call before the end of the year, so we can use these 20 visits -- because after that we'll have to get another script from the doctor, another insurance approval and another re-certification...

And I tell you, some days I feel like there is a conspiracy out there, set up just to drive me crazy....

2 comments:

Anonymous
said...

I would love to say, "And it too shall pass" but our health care system is so screwed up, and it just seems to keep getting worse. I know some of that frustration from my own experience, but it was nothing like you continually experience. My paper work was normally once a year, along with the re-certification.

Hi DianeJust stopping by you let know I feel your frustration..I have experienced some of what you are going through but not that often...

Our last home health care dropped the ball after the doctor ordered more therapy ...so Rick told them he would get a new company next time...they got so big ...no one knows what is going on ...and the lead people keep changing so no continuity...

Too bad because the therapists are good and they are being jerked around as well

Hi to Bob and we will keep you guys in our thoughts and prayers

Take careTheresa

PsMy friend in St Pete was a caregiver for her hubby ...he was near 20 years older than her...he just recently passed away (cancer) She said it is much harder losing him...she is having a difficult time...

Welcome To Our Pink House

About Me

Bob and I were married 09/16/94. He is my soulmate, the love of my life. Bob is an artist and I am a writer.
On 10/20/10, Bob, following his doctor's advice, underwent a carotid endarterectomy. When I left him in ICU that night, he was fine and I thought in good hands. Two hours after my departure, a nurse noted on his chart that Bob's speech was slurred and his right arm was paralyzed. The nurse did not call a doctor. Later that night, the nurse noted that Bob could not move his right arm or leg, still a doctor was not called. The next morning, the nurse noted that he was paralyzed on the right side, a "12" on the Glasgow Coma Scale, disoriented and confused, but no doctor was informed. I arrived at 9:00 a.m. and immediately called for the doctor. He was rushed to surgery. It was 12 hours too late. The CAT scan showed 2/3 of his brain had been damaged. I was told he would not survive. Somehow, he did.
Bob was discharged from the hospital on 12/31/10 and, although the hospital wanted him sent to a nursing home, I brought him home instead. This is the story of our journey since that day. This is also a love story.
(Bob passed away 5/28/15 and I am trying to survive....)